Internal medicine journal
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Internal medicine journal · Nov 2019
Ethical considerations relating to healthcare resource allocation decisions.
Public policy decisions about patients' access to limited healthcare resources must be defensible and responsive to the interests of those affected. Decision-makers should articulate their reasoning and recommendations so that citizens can judge them. While the context of policy decisions will differ, their legitimacy depends upon the transparency of the reasoning, the accountability of the decision-makers, the testability of the evidence used to inform the decision-making and the inclusive recognition of those the decision affects. An example of applying this framework to resource allocation is that of approving effective high-cost anticancer drugs in a timely fashion.
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Internal medicine journal · Nov 2019
Multicenter Study Comparative StudyAssessment of agreement and time in therapeutic range of capillary versus venous international normalised ratio in frail elderly people in a nursing home.
Vitamin K antagonists are widely used, yet have a slim therapeutic margin and high iatrogenicity. Patients are monitored through international normalised ratio (INR) by venipuncture, but coagulometers could measure INR by capillary puncture. ⋯ Concordance was good and mean time in therapeutic range (TTR) markedly increased. Capillary INR is thus reliable, could improve TTR and decrease iatrogenicity.
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Internal medicine journal · Nov 2019
Review Case ReportsThe significance of anti-granulocyte-macrophage colony-stimulating factor antibodies in cryptococcal infection: case series and review of antibody testing.
We report two cases of cryptococcosis, associated with anti-granulocyte-macrophage colony-stimulating factor antibodies. We review this recently identified acquired form of autoimmune immune deficiency and discuss the potential applications of granulocyte-macrophage colony-stimulating factor antibody testing by enzyme-linked immunosorbent assay.
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Internal medicine journal · Nov 2019
Multicenter StudyImpact of access to novel therapies on the initial management of castrate-resistant prostate cancer: an Australian multicentre study.
The impact of regulatory approvals of new therapies for castration-resistant prostate cancer (CRPC) in Australia is unclear. ⋯ Over time, clinicians are favouring earlier introduction of life-prolonging systemic treatment at the development of CRPC. This trend is largely driven by substantial uptake of novel androgen receptor signalling inhibitors as the preferred initial treatment for CRPC patients.